Term
| Describe the prevalence of mood disorders in Canada. |
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Definition
| Canadian studies: 4.1% to 11%. Females are twice as likely to depressed (except in seniors 65+). Bipolar disorders are distributed equally between males and females. |
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Term
| How does mood disorder presentation change with age? |
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Definition
| Mood disorders are fundamentally similar in children and adults |
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Term
| Describe major depressive disorder. |
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Definition
Extremely depressed mood state that lasts at least 2 weeks
duration and is typically 4-5 months. Feelings of worthlessness/lack of concentration.
Anhedonia (loss of pleasure)
Typically involves recurrent depressed episodes. |
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Term
| Describe Persistent Depressive Disorder |
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Definition
| Persistently depressed mood that continues for at least 2 years and is typically milder than MDD. Can persist up to 20+ years. Later onset (typically early 20's) or early onset (before 20) which results in greater chronicity and poor prognosis. |
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Term
| What are some defining features of premenstrual dysphoric disorder? |
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Definition
| Expression of mood liability, irritability, dsyphoria, and anxiety symptoms that occur repeatedly during the premenstrual phase of the menstrual cycle. Must be present for majority of cycles for 1 year and confirmed by prospective daily ratings of symptoms. |
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Term
| How prevalent is premenstrual dysphoric disorder? |
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Definition
| Approximately 1.8%-5.8% of menstruating females |
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Term
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Definition
| Exaggerated, elated, euphoric mood OR irritable mood. Cognitive symptoms like grandiose, deluded, psychological dysfunction, flight of ideas/rapid speech. Can last a week to months. |
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Term
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Definition
| Same symptoms as manic episode but less severe and symptoms of shorter duration (days as opposed to months). Unlike manic episode, doesn't necessarily involve goal directed activity, just lots of energy. |
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Term
| Describe bipolar I disorder |
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Definition
| Alternations between full manic episodes and major depressive episodes, meeting full diagnostic criteria for both mania and MDD during those episodes (MAY show evidence of psychosis). Age onset is 18 years, and it is chronic in nature. |
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Term
| Describe Bipolar II disorder |
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Definition
| Alternations between hypomanic episodes and major depressive episodes, meeting full diagnostic criteria for both hypomania and MDD during those episodes (also may include psychotic features). Age onset slightly later than bipolar I (around 22 years) and 10-13% of cases progress to bipolar I disorder. Also chronic. |
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Term
| Describe Cyclothymic disorder. |
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Definition
More chronic, but less severe of version bipolar disorder
Hypomanic episodes alternate with depressive episodes (that do NOT meet criteria full MDE). Pattern must last for 2 years (only 1 year in kids and adolescents). Age onset 12-14 years, most are female, high risk bipolar I or II. Chronic and lifelong. (no breaks of more than 2 months between episodes). |
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Term
| What are depressive disorders with anxious distress? |
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Definition
| Anxiety symptoms present during manic, hypomanic or depressive episodes. |
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Term
| What specifier describes manic/hypomanic symptoms present along with depressive symptoms? |
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Definition
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Term
| Mood congruent/incongruent hallucinations/delusions occurring during manic, hypomanic or depressive episodes. |
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Definition
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Term
| What is peripartum onset in relation to depressive disorders? |
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Definition
| Mood episodes having onset either during or post pregnancy. |
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Term
| Describe depression with seasonal pattern |
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Definition
| Temporal relationship between the onset of manic, hypomanic or depressive episodes and a particular time of year |
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Term
| What bipolar disorders would meet criteria for rapid cycling? |
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Definition
| Presence of at least 4 mood episodes in the previous 12 months that meet criteria for mania, hypomania or depression |
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Term
| What is depression with catatonia? |
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Definition
| Marked psychomotor disturbance (severely decreased motor activity and/or engagement, or excessive/peculiar motor activity) |
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Term
| Bipolar disorder that presents with loss of pleasure or reactivity to pleasurable stimuli would be termed ____. |
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Definition
| Bipolar disorder with Melancholic features |
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Term
| Atypical Features of bipolar disorder include: |
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Definition
| Mood reactivity, significant weight gain or loss, hypersomnia, leaden paralysis, severe rejection sensitivity. |
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Term
| How do specifiers influence diagnosis of a mood disorder? |
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Definition
| There isnt a minimum number required for a diagnosis, just a helpful way to describe a specific persons disorder. |
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Term
| What is known about genetic influences on mood disorders? |
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Definition
Every single disorder is this class has a high concordance rate for twins...
46% of identical twins will have disorder if twin does as well.Vulnerability to anxiety and depression may also be linked.
If one twin is unipolar, other twin was likely to have depression rather than bipolar. Severe disorders=higher rate in families. Anxiety and depression may be inherited together. |
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Term
| Which neurotransmitter systems are implicated in mood disorders? |
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Definition
| Low levels of serotonin implicated in mood disorders, but only in relation to other neurotransmitters: NE & DA. |
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Term
| What is the permissive hypothesis about mood disorders? |
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Definition
| low serotonin levels permit other neurotransmitters to become dysregulated |
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Term
| Which endocrine system components may be dysregulated in mood disorders? |
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Definition
| Elevated cortisol and dexamethasone suppression test (DST): Decreased suppression of cortisol in depressed patients after dexamethasone injection. |
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Term
| Describe sleep disturbances in depressed patients. |
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Definition
| quicker transition to REM and intensified REM. Reduced slow wave (stage 4) |
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Term
| How might learned helplessness lead to the development of depression? |
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Definition
Patients learn to make negative attributions about their current situation, future situation and global situation (feeling like negative events will disrupt their life).
They develop a negative attributional style. |
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Term
| What is Beck's Cognitive Theory of Depression? |
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Definition
Depressed persons engage in both cognitive errors and negative cognitions. These include arbitrary inference (overemphasize negative) and overgeneralization (generalize negative aspects of an event or experience to other aspects of it).
The depressive triad is the tendency of depressed patients to think negatively about themselves, the world and the future. |
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Term
| What is the gender imbalance across mood disorders? |
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Definition
| Women more likely, except for bipolar. |
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Term
| How are mood disorders treated? |
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Definition
| Medication (tricyclics, SSRIs, MAO inhibitors), Electroconvulsive therapy, CBT therapy and interpersonal therapy. |
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Term
| Weight the risks and benefits of tricyclic antidepressant treatment |
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Definition
| Alleviate depression in 50-70% of patients. Works by blocking uptake of NE and other transmitters, leading to densensitization and downregulation. Negative side effects like blurred vision, dry mouth, GI irritation, weight gain, sexual dysfunction. Can be toxic if overdose, so there is a risk of suicide. |
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Term
| Weigh the risks and benefits of Monoamine oxidase inhibitors for the treatment of depression |
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Definition
| Blocks monoamine oxidase, increasing levels of NE and serotonin. Leads to densensitization and downregulation within the system. Dangerous interaction with tyramine in foods. |
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Term
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Definition
| Selective serotonin reuptake inhibitors. Increase serotonin. Physical agitation and sexual dysfunction can be side effect. |
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Term
| What is lithium carbonate used to treat? |
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Definition
Bipolar disorder. Helps reduce manic episodes in severity and frequency. Can cause lowered thyroid functioning and poisoning if not regulated. Also causes substantial weight gain.
Might effect regulation of Na and K in the body, or limit availability of NE and dopamine. |
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Term
| Electroconvulsive therapy |
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Definition
| Involves inducing temporary seizures with electric shock. Used only in severe cases of depression, sometimes bipolar. 6 to 10 treatments. 50-70% of people improve but relapse is common (60%). |
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Term
| Psychological treatments for depression |
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Definition
| CBT to correct negative attributions, behavioural activation (force people to do things) and interpersonal therapy. Combining drugs with treatment may be beneficial in improving outcome and decreasing chance of relapse. |
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